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HomeMy WebLinkAbout0027 HORSESHOE LANE m 4 na r' • yy , If • , r. C. �"� / iL__�_____ � / _ c/ �� -- . � -. - ,,��y -, .. H' - - .. � > � ,. ,. _ .. � r ,� ',j• _ .. � � �. _. ' .. :, j .. � � � t Town of Barnstable Building e' � PostThlsCard So That rt rs V�sible�Fromahe�Street�A roved Plans.;M,ust be�Retamed on Job and;`this�Card Must be,Kept, BAlL[t`ASILtL6. TA mmA�; ,� Posted Until�Flnal Inspection Has:Been Matle � � � a ?s � �-� `�� ���� �� a� ;63p ♦ �, :" `� .. . .. x •,,, Y. g'. kg. .. ':. `,`?:'fix.,s ::�r =.W,.here a.Certificateof.,Occa anc �is'Re uired,such�Buldmshall Not:be Occupied�untlf a.,Final Inspection has been�made ��_` er •�t �a��.". ... �.� a�„��,�.�.,.:p ,.a yam.�q:�o .:� c :� M.v.. , .��.��,.�.�W... ��ar� •w ��,�.. ,_.��.,�... �.�, :...x:�K..:.�s:�s: ......,,�.,��.;, ,.,�., >_. Permit No. B-19-498 Applicant Name: Craig Bishop Approvals Date Issued: 02/15/2019 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 08/15/2019 Foundation: Location: 27 HORSESHOE LANE,CENTERVILLE Map/Lot 206 081 003 Zoning District: CBDCRNB Sheathing: Owner on Record: KAIN, MARTIN J 1 Contractor Nam'6 � Craig P Bishop Framing: 1 Address: 327 ASHMONT ST 4 Conztractor License CS 109777 2- BOSTON, MA 02124-3813 �.w Est Protect Cost: $667.00 Chimney: I Description: Air Sealing&Weatherization Permit Fee: $85.00 I Fee Paid Insulation: Project Review Req: Signed installers certificate required to;c1' _ $85.00 1. F Date 2/15/2019 Final: MMI e �dls�seM Plumbing/Gas g Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six monthsafter issuance. All work authorized b this permit shall conform to the approved a licetion and the"a roved construction document's fo'r�which this permit has been granted. Rough Gas: Y P Pp PP � PP x� �<All construction,alterations and changes of use of any building and strut- in be incompliance with the local zornng by laws and codes. 4 w Final Gas: This permit shall be displayed in a location clearly visible from access street d road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. , Electrical The Certificate of Occupancy will not be issued until all applicable signatures by,the Building and Fire Officia s are provided on this°permit. Minimum of Five Call Inspections Required for All Construction Work: r` Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection , 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final' Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT i OR'2 0 2020 av E aIMv sO�nrrt� ils ®wN OF BARNSTABLE 378 Route 130 Sandwich,MA 02563 PH:774-205-2001.844-90-AUDIT Permit Affidavit Permit#:. Permit#B-19-498- I,Craig Bishop,confirm that the weatherization and air sealing work completed at 27 Horseshoe,tanb-CeriteryilleI For Kain -has been completed in accordance with 780 CMR. Signature: 1 3/16/20 Si g Date: r f6jU�� Ile- - �M p Town of Barnstable *Permit ft r �p� F—Vires 6 monthsfrom issue date } Regulatory Services Fee ,: _-- a BARNSTABM e MASS. �' Richard V.Scali,Interim Director i639. ♦e aTFe►wA't� ���!ltlllrfl�� ��� Building Division Tom Perry,CBO,Building Commissioner 2 2��5 200 Main Street,Hyannis,MA 02601 SEP N"vw.town.barnstable.ma.us gpRNSTABLE Office: 508-862-4038 TOWN OF. E b8-790-6230 EXPRESS PERWI APPLICATION - RESMENTUL ONLY Not Valid without Red X-Press Imprint Map/parcel Number ,7,0&/0$l 00.3 �, Ile, Proppe/erry Address oZ 7 110r,Sesh 0 e kR/Ie- E24esidential Value of Work S f �� — Minimum fee of S35.00 for work under$6000.00 , Owner's Name&Address AV t V+ill, [�a if) _,Z7 Z6 3 2— Contractor's Name n aj Q;nc „ S f Rr t6 el �n i Snn Telephone Number( p 1)7 ZZ g-q k o Home Improvement Contractor License_(if applicable) !7 3 U Email: Construction Supervisor's License E(if applicable) 05 EgWorkriran's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I°am the Homeowner I have Worker's Compensation Insurance Insurance.CompanyName A!ej nGuy' :..nSu<gY1Ce— �unv Workman's Comp.Policyr 3 91-1 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shin x V. All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) PR,eplacement e-side Windows/doors/sliders.U Value B/ (maximum.35) of down z of ors:—I - ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspec ons requ' ..Separate Electrical&Fire Permits required. - *Where required: Issuance of this permit does not exempt compliance with other town department regulations,Le.Historic,Conservation,etc. Note: Propertyg.Owner must sigh Property Owner Letter of Permission. , A copy the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Y QA)NrPFILES\F01;bMS\building permit fomtsEXPRESS.doc _ Revised 061313 Renew �r. a R oN EIVAL By ANDERSEN `7 I - 6v CFst A 41��a'G5 �r.s. ')0,Allii--7 8tn:+id'• i�tauelln 111 Cw�l, csaaa.m�a.te Phim RW%4-22B,d Fae 401 ht IwLns' nd�9�hd'grroy-I�d3 el�`hfia .�i " x..�+ro�f'ai�a ,e•gfrst�.,.r � �.0�3 CI1mo 0' fi4b w AND 1POORAIRMODELING`AGNSE 1 �neh+4;rz«ale�eseSgSt�oe a+4' Gedc Fw_'eac, , [ Le • v!4nenar vaee lluyk eo)Ire"joinoly midi xyvr`lly agates qo pu Rlr.,a-ifir lnvdnaas atLdAP,e�ceM�pes'dd Satrheanr 1 r�l�eoali W i iddows. 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LATER=I�LI KMWr OF f It MfSY,4/NCE— TKMT11AM3ACn,O f ii '�d111tCE1.TFQS1`It/tl!1AM�`TODfk_ .aei4r-ra.w irr�er;�.. OEM RbIO ow,W119oe Ct�-A'e r I IffCopr..Ffnit L Southern: New England Windows d.b.a Renewal by Andersen of SNE Massachusetts-DepartnreM of Public Safety Board of Building Regulations and Standards Construction Supervisor License; CS-095707 BRIAN D DENNISON 7 LAMBS POND ICIR Charlton MA 01507 _ J,,�,,,•,tJ�t�.'I "`` Expiration Commissioner 0910&12016 t - - Office of Consumer Affairs Id Business Regulation 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration _ Registration: 173245 / Type[ Supplement Card Expiration: 9/192016 SOUTHERN NEW ENGLAND WINDOWS LL t, DENNISON BRIAN -----.---— = _.. 26 ALBION RD LINCOLN,RI M65 Update Address and return card.Mark reason for change. _ SCAt O 2CM-0411 _ I []Address Renewal (_j Employment Lost Card �"%b.'fav,,.nonrk..l�/c�c3ifi�«dwet/ Rice of Cuosnmcr Affairs&Rusiness ftolation License or registration valid for individul use only E IMPROVEMENT CONTRACTOR before the expiration date. irfound return to: _ Office of Consumer Affairs and Business Regulation Registration: 173245 Type. 10 Park Plaza-Suite 5170 Expiration: 91192016 Supplement and Boston,MA 02116 SOUTHERN NEW ENGLAND WINDOWS LLC. - RENEWAL BY ANDERSON - DENNISON BRIAN ' 26 ALBION RD i LINCOLN.RI 02865 Undcrsecrctary ^Not valid without signature The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 1 Congress Street, Suite 100 Boston,MA 02114-2017 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): SOUTHERN NEW ENGLAND WINDOWS Address:26 Albion Rd City/State/Zip:Lincoln, RI 02865 Phone#:401-228-9800 Are you an employer? Check the appropriate box: Type of project(required): 1.ME I a employer with 20+ 4. ❑ I am a general contractor and I employees(full and/or part-time). * have hired the sub-contracto 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp. insurance. # 9. ❑Building addition required.] 5. ❑ We are a corporation and its ME]Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no 13.0 Other Door Replacement employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tcontractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:ARGONAUT INS. CO. Policy#or Self-ins. Lic. #:WC 928058352394 Expiration Date:8/21/2016 Job Site Address: -• oZ -7 f1ri/'S-e<-Xd e 14/IP City/State/Zip: dlely/le Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date) Failure to secure coverage as required under Section 25A-of­AIGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA foi insurance coverage verification. I do hereby cent fy under 1wins and penalties of°perjury that the information provided above is true and correct. r Si afore. Date: Z L,2UI S� Phone#. 4012289800 Official use only. Do not write in this area,to be completed by city or town official. City or Town: PermitlLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r SOUTNEW-01 PARKERNATHCO CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES j BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED i REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsernerlt(s). PRODUCER ; `� Willis Certificate Center ; Willis of New Jersey,Inc PHONE 945-7378 888 4S7 2378 -� cla 26 Century Blvd i�Na rwi.(877) tAlc wnx P.O.Box 305191 Nashville,TN 37230 6191 i INSURER AFFORDING COVERAGE i NARC tNsuRER A-.Selective Insurance Company of Souffieast 13992E INSURER a:OneBeacon Insurance Company 21970 Southern New England Windows LLC ;DIWA Renewal by Andersen lusuRER C;Argonaut Insurance Company 19801 26 Albion Road :INSURER D: Lincoln,RI 028651 INSURER E: i INSURER F- COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I ' INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO MICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. P ILTRR TYPE OF INSURANCE 1 POLICY NUMBER �� POUCYEXP I LIMITS A X COMMERCIAL GENERAL LIABILITYI ( i EACH OCCURRENCE A $ 1,0OO,OQtI 1 AIMS MADE OCCUR X t �.S 2029459' 0811012015;08F10P2016 1 PREMISES (Es occwra ca) $ 100* -- I MEDEXP.(ARryor4pemn) ;$ 10,0" s :PERSONAL a aov lAtA I$ I'm 'm. GETPL AGGREGATE LIMIT APPLIES PER:PRO GENERAL AGGREGATE ($ 3,000 . POLICY®.JECT C=LOC ( i PRODUCTS-COMPIOP AGG I$ OTHER: I t I g AtIT'OMiOeiI.E LtAalLrrY OMBiNEDSiNGLELIMIT accident) S ,fir i )k X t ANY AUTO i X S 2029458 0811012015 08/1012016 BODILY INJURY(Per per3on) s ALL OWNED SCHEDULED BODILY INJURY 1 AUTOS p AUTOS i ( ! { (P--ddeq S i X 'HIRED {X (AUTO OS I ( j i PROPERTYDAL7AGE $ 1�-TI i Peracewerd) UM$RSLLAiJAB OCCUR i I i EACH S It EXCESS UA@ CLAIMS MADE I AGGREGATE I S I DEED RETENTION S $ WORKERS B CPREORAPdREITEdTBOERRIPEAXRCTLINUEDRE/DEJ?C£CU P OTM- AND EMPLOYES'LIABILITY X Y/NI i ER TIVE B= 081/2015?OB12112018EL EACH S 1, 0 ,00 IO 1 Y In NH) i EL DISEASE-EA ErdPR.O S 1,000, IPyyeess describe under i {DESCRIFnONOFOPERATIONSbebw ! i E.L.DISEASE-POLICY LIMIT S 110001M C Workers Compensation C928OM52394 08/21/2015 08/2112016 See Attached i j I t DESCRIPTION OF OPERATIONS I LOCA71ONS I VE14=M(ACORD 101,Additional Remmksllchedule,may be atbched I mom space M required) THIS CERTIFICATE VOIDS AND REPLACES THE PREVIOUSLY ISSUED CERTIFICATE DATED:SMI/2015 Auto Policy includes additional insured when required by written contract/agreement as per policy form. HSS Holding Corporation,Irv-and any,subsidiaries are included as an Additional Insured as respects to General Liability when required by written contractlagrteement as per policy form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE i THE EXPIRATION DATE THEREOF, NOTICE vaLL BE DELIVERED tN it ACCORDANCE WITtE THE POLICY PR;OVIstONs_ t I I AUTHORIZED REPRMENTATRVE i ©1988-M4ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Town of Barnstable *Permit#0���0��� Expires 6 months from issue date Regulatory Services Fee kk I C�- Thomas F.Geiler,Director Building Division C 5f Is�oB Tom Perry,CBO, Building Commissioner 200.Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230. EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Noot Valid without Red X-Press Imprint Map/parcel Number � Pro erty Address Yoi-4.,elve,o Lpwrr, /N oeo Residential Value of Work Minimum fee of$25.00 for work under$6060.00 Owner's Name&Address a ('�j 7 - 2 99 1 of�5 A De_. L4- Contractor's Name NUJ 1b" �P�' / k, 061 lL 5 Telephone Number T S b Home Improvement Contractor License#(if applicable) —Constration agervisor'-s-L-cense t-(ifapph-cabiej orkman's Compensation Insurance a Check one: ®PRESS AIT ❑ I am a sole proprietor F_j1j am the Homeowner MAY 13 2008 I have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris.will be taken to ❑Re-roof(not stripping: Going over existing layers of roof) ❑ Re-side 3. f _ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc: ***Note: Property Owner must sign Property Owner Letter of Permission. e-Harff prov nt Contractors License is required. SIGNATURE Q:Fomu:expmtrg Revise061306 1 • �' V�(.G �OI�U/7ZO�JZUIP[GL4/G ���KG(If.GLD License or registration valid-for individuI use only Board of Building Regulations and Standards before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Board of Building Regulations and Standards One Ashburton Place Rm 1301 Registration: 119535 Boston,Ma.02108 Ulu Expiration: 7/24/2009 T(# 130185 Type: Private Corporation MOON ASSOC INC 1 JAMES MOON f^—�-- - 1137 PARK EAST DR. Not valid ithout signature WOONSOCKET,RI 02895 Administrator Board of Building Regula ions and Standards One Ashburton Place' - Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Registration: 119535 Type: Private Corporation Expiration: 7/24/2009 Tr# 130185 MOON ASSOC INC JAMES MOON 1137 PARK EAST'DR. WOONSOCKET, RI 02895 Update Address and return card.Mark reason for change. DPS-CA1 t3 50M-05/06-PC8490 Address Renewal Employment Lost Car( The Commonwealth of Massachusetts Department of Industrial Accidents Qf,juice of Invesdgations 600 Washington Street Boston,MA 02111 www mass govfdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name(Business/Organization/Individual): MO VP P Address: %/.3 a r'/� k qas � _�)91' City/State/Zip: 6)r91�So Phone#: Are you an employer?Check the appropriate box: Type of project(required): LZ I am a employer with 1 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6• ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp.insurance) 9• ❑Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11-❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL .12. insurance required.]t c. 152,§1(4),and we have no ❑Roof reps 'employees.[No workers' 13. 10ther comp.insurance required.] *Any applicant that checks box#i must also fill out the section below showing their workers'compensation pommy information.t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box mast attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors have em ploy=,they must provide their workers'co policy number. �•Po Y I am an employer that is providing workers'compensation!insurance for my employees Below is the policy and job site information. Insurance Company Name: ,D!?(zc, Policy#or Self-ins.Lic.#: 8�$ Expiration Date: D 7111 00 140:i: Job Site Address: r- i �fl� City/State/Zip: 1 C 1 _P,Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MG c. 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coveracrP verification. I do hereby cer ' un er t aims=hio jury that the information provided above is true and correct Si lure: / �--- Date: �7 Phone#: o l s7 6 ! � — g y� /9�i y FOther only. Do not write in this area,to be completed by city or town o�ciaL n: Permit/License# hority(circle one): Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector r son• Phone#: 0 w ]h i M SN r' R Renewal byAndersenmLA �. —0. V --k m WINDOW REPLACEMENT an Au. .. ,upany N WoodNinyl Composite IF „„ \ i l4afiroml F ms�atcr —1 3 Ratllq aalY 3== Dual Double Hung on Low E < o . ., _ 0 ,1 100-00390547-005 3 -Zi a ENERGY PERFORMANCE RATINGS - o U-Factor(U.S)/I-P Solar Heat Gain Coefficient CIO c W Om ,30 Om3l 00 a ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0053 t Manufaeturor stipulates that these ratings conform to applicable NFRC procedures lu,ante ruining Whole product �v .. performance.NFRC ratings are determined fora fixed set of environmental conditions and a specific product Size. r, ( NFRC does not recommend any product end does not warrant the suitabillty of ehy product forany spaclfic use. A t - .. Consult manufacturers literature for other product performance Infornatlon. .yr IV www.nfrc.org. SEq� This product meets LireAl. r seats environmental V�: standards governing energy efficiency,heavy .. p metals In the frame and »r. .. L. 4V sash materials packaging,and consum r® _ CERt education materials. DESIGN PRESSURE(PSG ` Ip ?. •. M www wr I LC�5 Sloped Sill DH IN RbA DB Slop - - V Tested to N.4IS-0?orAAMA/WDMA!(SA IUI/LS/AJ40-05 Manufacturer stipulates rnnrmr.ran.P to the aprLcahle smndnrds f r Meets orexceedS M.E.C.,C.E.C,61.E.C.C.Air lnfilltration requirements WDMAHellma,k uu,l hcal,on proyrent. ' + 3 � x 1 - rs. Frain:Shaunna Robinson,.Hunter Insurance At:Hunter.Insurance,Inc. FaxID: To:Denise Date:9/17107 12:56 PM Page.2 of 3 DATE(MMIDDIYYYYI A��>Ra CERTlF1CAT'E OF LIABILITY ti�15U`RAiVCE oPID s MOONA-1 09/17/07 THIS CEATIFICATEIs ISSU9b As A'MATTER.OF INFORMATION PRODUCER ONLY AND GOJdFER S NO RCGHTS UPON'fHE:CERTIFICATE inter Insurance, Inc. HOLDER THIS CBR71FICATE`'I*56 NOT AMEND,EXTEND OR ---sS9 Old River Road, P.O. Box 1 ALTERTHECOVERA0EAFFORDED`B.Y THE POLICIES BELOW. Manville RI 02838-0001 Phone: 461-769-9500 Fax:401-769.-9502 INSURERS:AFFORDING COVERAGE NAIC INSURED INSURER A pational Oran a inaumanao cn. _ Moon Associates Inc. INSURER B: Boaoon Butuai Innis=anca DBA Gutter Heiiaet INSURER C: DBA Renewal bV Ancjersen of RI -— - 1137 Park EastDt ve INSURER D Woonsocket RI 02895 INsuaERE: COVERAGES n-F POLICIES OF INSURANCE LISTED BELOW HAVE:eEEN-ISSUED TO THE INSURED YJ � TYTSAINGv ! H ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W1TH.RESpECT To WHICH THIS C'cRTIFiCATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED DY 114E'POLICIES:DESCRIBED FTEREIN 15 SUBJECT TO ALL THE-(ERNS,EXC7 USIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE.BEEN REDUCED BY PAID CLAIMS. PDEMV OW LTR NSR TYPE OF INSURANCE 'POLICY NUMBER DATEjMM/Dl]Ml1 .DATE`EXPIRATF LIMITS GENERAL LIABILITY EACH OCCURRENCE f 10 O D 0 0 O-_ D �oF�— $500000 A X COMMERCIAL GENERAL LIABILITY MPS26619 03/16/07 09/16/08 pkWiSEs(Eaec?ctrenca) CLAIMS MADE Ex]OCCUR - MED'ExP fAIW« POISon) $10000 _ PERSONAL&ADV INJURY $ 1000000 GENERAL AGGREGATE $2000000 GENt AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $2 0 0 0 0 D 0 POLICY Co-i AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $10 0 0 O O 0 A X ANY AUTO BIS26619 09/16/07 09/16/08 (Esacdde!) ^ ALL OWNED AUTOS BODILY INJURY $ (Per pmen) SCHEDULED AUTOS ---- HIRED AUTOS BODILY INJURY $ (Par.acmdent) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per ac kIW) GARAGE LIABILfTY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHfiR THAN EA ACC f AitTOONLY' AGG $ EXCESS/UMBRELLALIAWLITY EACH OCCURRENCE $1000000 A X OCCUR CLAIMS MADE GUS26619 09/16/07 0'9/16/0B AGGREGATE $ --- DEDUCTIBLE - _ f ------ X RETENTION $1,60.0 0 $ I. WORKERS COMPENSATION AND 70RY LIMITS ER B EMPLOYERS'LIABILITY L8t✓$6 10/01/07 10/01/08 EL EACH ACCIDENT $ 500000 ANY PROPRIETOR/PARTNER/EXEr UTIVE - - OFFICERlMEMSEREY.CLUDED9 E.L.'DISEASE-EA EMPLOYEE $S00000 If yes.descnbe under E.L.DISEASE-POLICY LIMIT $500000 SPECIFY.PROVISIONS below OTHER DESCRI ON OF OPER TIONS 7 LOC T1oNS7 VEHICLES!EXCLUSIONS ADDED BY ENDOkSELT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION MoQNASS SHOULD ANY OF THE ABOVE LI DESCRIBED POCIES BE CANCELLED BEFORE THE EXPIRATION Moon Associates, Inc DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10_ DAYS WRITTEN dba .putter. 1�Y 10t NOTICE TO TWE CEIYTffICY1TE 4 HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO SHALL dba Renewal, -bq.Andersen IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 1137 Patti East Or rive RE@RESENTA11VE8.,. Woonsocket RI 02895 •q ,./ DAEPRESIENrATWE - LJ/LS/�./ ACORD 25(2001/09) 6 ACORD CORPORATION 1988 r^ i�• r i t �'m 'su � �� �. ¢ Is t � � l �.` >� r � � s u 01 - re a�l BY.ANDERSEN wind— •p]. ,r �� .. � 1 � of t i stomer Name -"� `r'----Y��.-!--- Year home Was built*,, qg �. Phone-Home. t / J �. ; 7 � — Order#_ _ �/ Ads, -- Phone-Work State.. Zip kQty. Width Height Style Type Specifications,Room,Color,Screens,Grilles Price "Defcription - i i °1Z x D .l V r 4 l Pre'x L.%IL or t ekkr(or` h x zlE, SOL OtL x tIdd lional, terms rxnr,/, c<inditions, xj t x -0 X X F Renewal by Andersen•Proposal, q 4 ria All of the above replacement windows and doors to be provided for the sum total of the amount stated in this agreement. Labor&Materials �/�' t; This proposal will remain valid for 30 days. Sales Tax' w Darr #1y ::?� - Rentwa16y Andenrn•Sa/er ReprcsentaslueSrurr Work Permit CDit el`h C I Customer Acceptance Total Amount of Agreement You are hereby authorized replacement windows and doorg required to complete this agreement for to furnish all r which the undersigned agrees to pay the amount mentioned in this agreement and according to the terms hereof. You,the buyer,may cancel this transaction at any time prior to midnight of «�CK❑Finance eposit Required the third business day after the date of this transaction.Please see attached y'° ¢� w. Balarice Due on Completion '� notice of cellation fo for an explanation of this right. . . .. .0. Cost of Unforeseen Repairs Dare .. _ io Approval S;gnamn. Any painting,staining or wallpapering which nuty be needed is not included in I this agreement unless specifically noted above.. Renewal by Andersen*Acceptance. - '- Please note that we are unable to bid on-rrpairing any unseen damage:However, +r t ifany unseen damage is discovered during installation,-sue will cbmp4u."and cha Uau - Rrar�a!by Aademen•'Managn Sg„am.e e u or ain upon your approval.At the end of the jab all %s � rg Y the reP o f 'construction debris will be removed and we wil l ll clean your'new windows and -NOT BINDING ON RENEWAL BY.ANDERSEN•uiITHOUT MANAGEMENT.ACCEPTANCE. the installation area. 'g," . s,,a Farm.Dumbutign:White-Renewal by Andersen,Yellow-Installation,Pink-Customer p l i ` Asfpt . _ h ... - - " P / of ZME Tpk, 1 O WII OI 13dru5 i<sae�j%► Expires 6 tnondts from issue dart "f #.! Regulatory Semces Fee � MASS Thomas Thomas F.Geiier,Dlreetor te7�. .0/dit►9. Building Division Peter F.DiNIatteo, Building Commissioner p o r-Sa7 p lER� IT • 367 Main Street, Hyannis,MA 02601w � Office: 508-862=038 MAY 1 0 2004 Fax: 508-7 90-6230 S�DENTI 0 EXPRESS PER11'IIT APPLIC N RE OVA �`-- ARNSTASLE Not Valid without Ra X-Press IXP"nt Vlaprparcel Number Po to o m O - Property Address � 1 C'� 'C S -� Value of Work ZResidential Ownei s Name&Address •M A R T I N Y A N F_ Contractor's Name To�hT N k N T y-L E R 'Telephone Number So�-�� ��5 f Home Improvement Contractor license#(if applicable) l —7 Ov Construction Supervisor's License-(if applicable) i , []Worlmtan's Compensation Insurance Check one: 0 1 am a sole proprietor I am the Homeowner a I have Worker's Compensation Insurance Insurance Company Name Work an's Comp-Policy Permit Request(check box) �-Re roof(stripping old shingles) Re-roof(not stripping. Going over existing layers of roof) Re-side . rl Replacement Windows. U-Value (maxinnmt•44) Other(specify) - fieo ,/�aoeaclzuaet7a ..:..... tioar�,at"i3uil�;irsG F.��ii�rsoei��n�#Srae�dards •Where required: issuance of this permit does not ex t compliance with o x b HOME itgv rt� T cor�r�zac ®R 819 i .N v dual Signature �-- Q:Forrra:expnrtrc:r.v-A%0601 : 7L;racr e,ry•_ e MIA 02672 �o�t►+e ro�ti Town of Barnstable Regulatory Services * snRxslne Thomas F.Geiler,Director 163;9..yJ& Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I 1MCV- I.,n , J r' ,as Owner of the subject property hereby authorize � d n to act on my behalf, in all matters relative to work authorized by this building permit application for: gn 110TSeZ'Jde- La.-7 e Ce4 (Address of Job) Signature of Owner Date Print Name Q:FORMS:O WNERPERMISSION